Registration Form


          
                            REGISTRATION FORM 
                     (For authors and non-authors)

     The Fourth International Conference on Machine Learning and Applications
                           December 15-17, 2005

              Sheraton Gateway Hotel, Los Angeles, California, USA 
                http://www.cs.csubak.edu/~icmla/icmla05


Please complete your details below:

Paper ID/paper number (authors only): _________________


First Name:_________________ Last/Family Name:______________________

Title (Dr/Mr/Ms/Prof.):___________ Position:__________________________

Company/Univ.:_____________________________________ Dept.:____________

Address:______________________________________________________________

City:___________________ State:________________ Zip/Postal Code:______

Country:___________________________ Phone:____________________________

Fax:_______________________________ E-mail:___________________________


Mailing Address (if different from above):____________________________

______________________________________________________________________


Registration Fee (if received by October 1, 2005):

                       Non-student ($500):    $__________

                 Full Time Student ($450):    $__________


Method of payment (check/credit card) __________ 

Amount enclosed or Paid by a credit card (in U.S. Dollars):    $__________

Payment reference number (if paid by a credit card) __________  

      

              
Notes:
       1. After October 1, 2005, registration will be accepted only if space is
          available. A late fees of $50 is applicable after October 1, 2005.

      2.  All checks/money orders should be made payable to "ICMLA".
          Payments must be in U.S. Dollars and cashable at any US bank.
          If you wish to pay by a credit card please see instructions below. 

      3.  To be eligible for student rate you must attach a letter from your
          Department Head/Chair that states that you are a full
          time student.  

      4.  Registration Fee will include the following:
          A copy of the conference proceedings;  
          conference dinner on December 16, 2005; 
          and coffee breaks.



          Signature:_________________________ Date:________________


How to register: 
Send the signed and completed registration form along with the
registration fee to:

                  Dr. Woogon Chung
                  ICMLA OFFICE
                  Department of Computer Science
                  California State University Bakersfield,
                  Stockdale Highway,
                  CA, 93311
                  U.S.A.
                  Email: wchung@cs.csubak.edu
                  Phone: 661 654 6757
                  Fax:   661 654 6960  

                  (Tell No. for use by DHL, FedEx, UPS, ...: 661-664-3082)


To use a credit card: 
If you wish to pay the registration fees by a credit card you should:

 i) Send the completed and signed registration form to Dr. Chung (address given above).
    You should include credit card payment reference number in the line 'Payment reference number'
    which you can obtain from Mrs. Loraine Navarro (contact details given below).

 ii) Mail/FAX/EMAIL the credit card authorization form to the following address:

               Mrs. Loraine Navarro
               Foundation Office
               California State University Bakersfield
               Stockdale Highway,
               CA, 93311
               U.S.A.

               Email: lnavarro@csub.edu
               Fax: 661 665 6915
               Phone: 661 664 3163


Credit card authorization form for the ICMLA'05 Conference
The cardholders name:
The card number:
The Card type (we do not accept American Express or Diners Club):
The expiration date:
Amount to be charged to the card:

Account to be Credited:  ICMLA Registration fees account

Signature of the cardholder (if mailed or faxed):